Endoscopic resection for undifferentiated early gastric cancer

Jie Hyun Kim, Yong Chan Lee, Hyunki Kim, Kyung Ho Song, Sang Kil Lee, Jae Hee Cheon, Hoguen Kim, Woo Jin Hyung, Sung Hoon Noh, Choong Bai Kim, Jae Bock Chung

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background and Objective: Endoscopic resection (ER) has become an important curative option for early gastric cancer (EGC). However, the application of ER for undifferentiated EGC remains controversial. The aim of this study was to evaluate the clinicopathologic outcomes of ER performed in undifferentiated EGC with special reference to histopathologic subtypes to examine the feasibility of ER in undifferentiated EGC. Design and Setting: Retrospective, single-center study. Patients: From January 2001 to April 2007, 58 lesions in 58 patients with undifferentiated EGC (17 poorly differentiated adenocarcinoma; 41 signet-ring cell carcinoma) were treated by ER at Severance Hospital, Seoul, Korea. Main Outcome Measurements: The therapeutic efficacy of ER was assessed according to en bloc resection, histologic complete resection (CR), lateral or vertical cut end-positive (including submucosal invasion), and recurrence rates in 3- to 65-month follow-up periods. Results: The en bloc resection and CR rates were 84.5% and 67.2%, respectively. The en bloc and CR rates in poorly differentiated were 82.4% and 58.8%, whereas those in signet-ring cell were 85.4% and 70.7%, respectively. There were no significant differences between poorly differentiated and signet-ring cell. However, all (100%) of the histologic incomplete resections in poorly differentiated were vertical cut end-positive, whereas 83.3% of these resections in signet-ring cell were lateral cut end-positive. The recurrence rate was 5.1% in CR during the follow-up period. Limitations: Retrospective, short-term follow-up period. Conclusions: ER may be a feasible local treatment for undifferentiated EGC if CR can be achieved. However, a different approach is necessary between poorly differentiated and signet-ring cell before ER to prevent incomplete resection.

Original languageEnglish
Pages (from-to)e1-e9
JournalGastrointestinal Endoscopy
Volume69
Issue number4
DOIs
Publication statusPublished - 2009 Apr 1

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Stomach Neoplasms
Signet Ring Cell Carcinoma
Recurrence
Korea
Adenocarcinoma
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Kim, Jie Hyun ; Lee, Yong Chan ; Kim, Hyunki ; Song, Kyung Ho ; Lee, Sang Kil ; Cheon, Jae Hee ; Kim, Hoguen ; Hyung, Woo Jin ; Noh, Sung Hoon ; Kim, Choong Bai ; Chung, Jae Bock. / Endoscopic resection for undifferentiated early gastric cancer. In: Gastrointestinal Endoscopy. 2009 ; Vol. 69, No. 4. pp. e1-e9.
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title = "Endoscopic resection for undifferentiated early gastric cancer",
abstract = "Background and Objective: Endoscopic resection (ER) has become an important curative option for early gastric cancer (EGC). However, the application of ER for undifferentiated EGC remains controversial. The aim of this study was to evaluate the clinicopathologic outcomes of ER performed in undifferentiated EGC with special reference to histopathologic subtypes to examine the feasibility of ER in undifferentiated EGC. Design and Setting: Retrospective, single-center study. Patients: From January 2001 to April 2007, 58 lesions in 58 patients with undifferentiated EGC (17 poorly differentiated adenocarcinoma; 41 signet-ring cell carcinoma) were treated by ER at Severance Hospital, Seoul, Korea. Main Outcome Measurements: The therapeutic efficacy of ER was assessed according to en bloc resection, histologic complete resection (CR), lateral or vertical cut end-positive (including submucosal invasion), and recurrence rates in 3- to 65-month follow-up periods. Results: The en bloc resection and CR rates were 84.5{\%} and 67.2{\%}, respectively. The en bloc and CR rates in poorly differentiated were 82.4{\%} and 58.8{\%}, whereas those in signet-ring cell were 85.4{\%} and 70.7{\%}, respectively. There were no significant differences between poorly differentiated and signet-ring cell. However, all (100{\%}) of the histologic incomplete resections in poorly differentiated were vertical cut end-positive, whereas 83.3{\%} of these resections in signet-ring cell were lateral cut end-positive. The recurrence rate was 5.1{\%} in CR during the follow-up period. Limitations: Retrospective, short-term follow-up period. Conclusions: ER may be a feasible local treatment for undifferentiated EGC if CR can be achieved. However, a different approach is necessary between poorly differentiated and signet-ring cell before ER to prevent incomplete resection.",
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Endoscopic resection for undifferentiated early gastric cancer. / Kim, Jie Hyun; Lee, Yong Chan; Kim, Hyunki; Song, Kyung Ho; Lee, Sang Kil; Cheon, Jae Hee; Kim, Hoguen; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong Bai; Chung, Jae Bock.

In: Gastrointestinal Endoscopy, Vol. 69, No. 4, 01.04.2009, p. e1-e9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endoscopic resection for undifferentiated early gastric cancer

AU - Kim, Jie Hyun

AU - Lee, Yong Chan

AU - Kim, Hyunki

AU - Song, Kyung Ho

AU - Lee, Sang Kil

AU - Cheon, Jae Hee

AU - Kim, Hoguen

AU - Hyung, Woo Jin

AU - Noh, Sung Hoon

AU - Kim, Choong Bai

AU - Chung, Jae Bock

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Background and Objective: Endoscopic resection (ER) has become an important curative option for early gastric cancer (EGC). However, the application of ER for undifferentiated EGC remains controversial. The aim of this study was to evaluate the clinicopathologic outcomes of ER performed in undifferentiated EGC with special reference to histopathologic subtypes to examine the feasibility of ER in undifferentiated EGC. Design and Setting: Retrospective, single-center study. Patients: From January 2001 to April 2007, 58 lesions in 58 patients with undifferentiated EGC (17 poorly differentiated adenocarcinoma; 41 signet-ring cell carcinoma) were treated by ER at Severance Hospital, Seoul, Korea. Main Outcome Measurements: The therapeutic efficacy of ER was assessed according to en bloc resection, histologic complete resection (CR), lateral or vertical cut end-positive (including submucosal invasion), and recurrence rates in 3- to 65-month follow-up periods. Results: The en bloc resection and CR rates were 84.5% and 67.2%, respectively. The en bloc and CR rates in poorly differentiated were 82.4% and 58.8%, whereas those in signet-ring cell were 85.4% and 70.7%, respectively. There were no significant differences between poorly differentiated and signet-ring cell. However, all (100%) of the histologic incomplete resections in poorly differentiated were vertical cut end-positive, whereas 83.3% of these resections in signet-ring cell were lateral cut end-positive. The recurrence rate was 5.1% in CR during the follow-up period. Limitations: Retrospective, short-term follow-up period. Conclusions: ER may be a feasible local treatment for undifferentiated EGC if CR can be achieved. However, a different approach is necessary between poorly differentiated and signet-ring cell before ER to prevent incomplete resection.

AB - Background and Objective: Endoscopic resection (ER) has become an important curative option for early gastric cancer (EGC). However, the application of ER for undifferentiated EGC remains controversial. The aim of this study was to evaluate the clinicopathologic outcomes of ER performed in undifferentiated EGC with special reference to histopathologic subtypes to examine the feasibility of ER in undifferentiated EGC. Design and Setting: Retrospective, single-center study. Patients: From January 2001 to April 2007, 58 lesions in 58 patients with undifferentiated EGC (17 poorly differentiated adenocarcinoma; 41 signet-ring cell carcinoma) were treated by ER at Severance Hospital, Seoul, Korea. Main Outcome Measurements: The therapeutic efficacy of ER was assessed according to en bloc resection, histologic complete resection (CR), lateral or vertical cut end-positive (including submucosal invasion), and recurrence rates in 3- to 65-month follow-up periods. Results: The en bloc resection and CR rates were 84.5% and 67.2%, respectively. The en bloc and CR rates in poorly differentiated were 82.4% and 58.8%, whereas those in signet-ring cell were 85.4% and 70.7%, respectively. There were no significant differences between poorly differentiated and signet-ring cell. However, all (100%) of the histologic incomplete resections in poorly differentiated were vertical cut end-positive, whereas 83.3% of these resections in signet-ring cell were lateral cut end-positive. The recurrence rate was 5.1% in CR during the follow-up period. Limitations: Retrospective, short-term follow-up period. Conclusions: ER may be a feasible local treatment for undifferentiated EGC if CR can be achieved. However, a different approach is necessary between poorly differentiated and signet-ring cell before ER to prevent incomplete resection.

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